“The children's thoughts are in red,” said Mustafa Shakr, a former principal in Damascus who now runs a school for more than 300 Syrian children in the Turkish city of Antakya near the Syrian border. “Even many of their drawings are done entirely in red.”

The uprising in Syria against President Bashar al-Assad, now in its 21st month, is having a profound and often disturbing effect on children. Hundreds of thousands have been uprooted to flee with their families, frequently after witnessing death and the destruction of familiar buildings and neighborhoods that used to signify safety and continuity. Many children who have stayed in Syria face bombardment, food shortages and bitter cold without fuel or school.

In their makeshift homes, dark thoughts haunt these young victims.

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“My younger sister had a dream the other night,” said 10-year-old Mahar, in a refu­gee camp near the Turkish town of Yayladagi. “She dreamed she went to Syria, killed Bashar and came back.”

Parents and humanitarian organizations are struggling to help. Many refugee schools have play rooms and art programs that encourage children to express their fears and start to regain a sense of normality.

But there is a shortage of professionals trained in psychology. The schools, staffed by Syrian teachers and administrators who themselves fled the violence, often make do with volunteers.

“I'm a gynecologist,” said a woman who would provide only her first name, Manar, who is helping children who exhibit traumatized behavior at a seven-room school fashioned from a small convention center in the Turkish city of Gaziantep. Pointing to her team partner, she added, “She's a civil engineer.”

“We're not specialists,” she said. “We're just here to help the kids learn to become better. We encourage them by saying, ‘Be a good example for your friends,' and talk to them about the problems they brought with them from Syria.”

An 8-year-old boy from Aleppo refused to talk for 15 days after arriving. When he finally spoke, his first words were, “They burned my school.”

A first-grade girl who saw her uncle run over by a tank, severing his leg, is frequently absent from class and often goes home with a high temperature.

A boy playing soldier shouted out, “I'm with the FSA,” the acronym for Syrian rebel forces. As a teacher approached, the boy hid under his desk and cried out fearfully, “Don't tell the army.”

Many of the 290 children at the primary school stage impromptu, daily protests against Assad, shouting revolutionary slogans in the courtyard.

“My son is the leader of the demonstrations,” said Um Mohammed, or mother of Mohammed, her face showing conflicting emotions of pride and chagrin with her 9-year-old boy. “I don't want my son to hate his country. But he hates his country and the state, and he doesn't want to go back.”

Though some children are clearly exhibiting symptoms of post-traumatic stress disorder, school officials and psychologists say they are a small minority. The experience of children in Nicaragua, Cambodia, the West Bank and Gaza suggests that most eventually return to their normal routines with no long-lasting repercussions, psychiatrists say.

“Research shows that memories are short-lived,” said Nadim Almoshmosh, president of the British Arab Psychiatrists Association who is coordinating efforts to provide mental health support to Syrian refugees. “Mostly, they come out of it. Of course, the longer it goes on, the more impact it will have. But eventually, most find a way of coping and move on.”

The traditional nature of Syrian society has both advantages and shortcomings in dealing with the psychological effects of war, Almoshmosh said.

It is not common for Syrians of any age to seek professional help from therapists because of the stigma attached to psychological problems.

“In Syria, children are not encouraged to express what they're feeling,” Almoshmosh said.

“But in the last 20 months, people have pulled together somehow in the face of a unified enemy,” he added. “Children who are going to school are part of a community, and that gives them support.”

Syria is a young country. Almost half its population is under 18, double the rate in the United States, and that youth is seen in the teeming refu­gee camps in neighboring countries, where more than 500,000 are living. At least four times as many people are displaced within Syria, many of them in either rough camps or in towns far from home, isolated in places where school takes a back seat to the necessities of survival.

At the Bashaer School in Antakya, school psychologist Montassin Bilar Assasa has heard his share of distressful stories.

A 15-year-old girl is afflicted with nightmares after she saw hundreds of militia members affiliated with the regime approach her house and, fearing rape, prepared to throw herself off the balcony. A 5-year-old girl whose family moved her from one refugee camp to another has lost all sense of security and involuntarily urinates several times a day. A 14-year-old girl who saw a 20-year-old shot to death outside her home now refuses to be alone for even a minute.

Almoshmosh said adolescents and adults may suffer more than young children because they fully understood the brutality of what they lived through or witnessed.

But Assasa said he believes teenagers also understand the principles for which a war is fought, making it easier for them to cope.

“At the age of 11 and older, they're more capable of dealing with these frightening events,” he said. “Children at this age develop abstract thinking. . . . They know the values of freedom and justice. That helps.”

Looking to the future

Rola Kadi, a Syrian American art student at Wayne State University in Detroit, has been giving art lessons to Bashaer's students. When she asks children who left the country several months ago to draw anything that's on their minds, they gravitate to images of the Syria of their dreams.

“They draw the revolutionary Syrian flag with words like freedom and peace,” she said. Sooner or later, she said, most children stop coloring the sea red and reach for the blue pencils and crayons.

While the school has referred the most severe cases of PTSD to psychiatrists, most children eventually emerge from the darkness with gentle coaxing.

Assasa, the school psychologist, said children who are afraid of the dark are placed in a room with their mothers by their sides while the lights are slowly dimmed. Each session lasts a little longer, and after a few months, most overcome their fears, he said.

It will be years before anyone knows if the emotional wounds caused by the conflict will leave permanent scars. Assasa, for one, hopes that in the end the next generation will be inspired by the war's aspirations, not destroyed by its bloodshed.

“My expectation is that the next generation will be marked by the positive side to all this,” he said. “They will embrace freedom, and reject unfairness. This will be the generation that will rebuild Syria.”

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